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Pregnancy Journal (week 6)

Dec 22, 2013 - 0 comments

Today, I'm 6w3d pregnant. We had quite a roller coaster ride this past week.  I had my first OB appt scheduled at 6wks ob 12/19.  However, 8am on Wed 12/18, the day before my appt, I woke up walking to the bathroom feeling wet down there.  I thought it was my suppository leaking.  But then I realize that I've been BLEEDING. Very heavily, soaked the pad, soaked thru my underwear, all of the bed sheet, and dripping bright red blood with clots into the toilet... I screamed and cried.  DH and DS came over and was shocked at the scene... There was so much blood that so thought I was gonna lose my baby for sure.  I called my OB's office in a shaking voice, and they asked me to come in right away.  

I cleaned up myself, and calmed down, thinking what if bleeding was from low progesterone, what if baby's still inside... I asked DH to give me a PIO shot (cheers for DH finally breaking through his fear and starting to give me shots with the power of love!!!) and took 400mg progesterone orally to pump up my serum p4 level before we leave for the doctor's office.  It was the longest 2-hr drive ever. We got there at 10:30am.  I was not steady on my feet from fever, low BP, blood loss, p4 side effects, and panic/stress....  It didn't take them long to see me.  Dr. R was very quiet - we all understood that there's nothing much to say but to do a transvaginal ultrasound to find out.

And he did! He found a sac. I asked if he could find a heartbeat for me.  He said it might be too early, but he could try... There was something flickering there.  It was kind of slow and hard to see.  He didn't measure the HR, just told me it's about 70-80 where they always start from but will pick up in the next few days to a week.  He asked me to come back for follow-up appt with his associate Dr J next week as he'll be out of town.  Dr. R said the bleeding was because the placenta implanted very low and very close to cervix, which irritates and puts pressure on my cervix causing my cervical blood vessel to rupture.  He took me off all the blood thinner, anticoagulant, fish oil, etc.

Thursday evening, I drove to Bay Area to spend the night in a prebooked hotel coz I have 8am dental appt Friday morning.  I was suddenly immersed by a profound sadness and just couldn't stop crying while I drove.  Friday morning, after my dental appt, I stopped by my PCP's clinic for a hCG/p4 blood draw (I requested for a standing order since I'm dx'd with threatened abortion).

My betas had been growing well and I thought this blood work will help me relax and provide some stress relief.  How wrong I was!  Monday 12/16, my beta was at 6574.  I was hoping to see a 10,000+ number. By the time I'm almost home, I got my results back - my beta had dropped to 6353 and p4 at 22.  I didn't go home and went straight to local urgent care. The doctor there reviewed my beta history and also thought it's likely a case of missed miscarriage with dropping beta and recent episodes of bleeding.  But she couldn't arrange for u/s after hour over the weekend.  

I was so anxious and stopped by the ER to talk to the ER nurse.  I just couldn't stop crying... All I wanted was to see her heart beat one more time... I know once my beta starts dropping, it falls very quickly and if I wait till Monday, there would be no chance that her heart is still beating... The nurse said get registered and the doctor can order an ultrasound for me, but I have to stop crying before I knew for sure...

It took 3hrs wait to see the ER doctor Dr. L. He was old and nice... I wrote down all my past beta hx for him, and he said his lab showed that my beta was increasing and not dropping.  Instead of 6353, the beta they got was 8362! But that's still only 33% increase over more than 100 hours, so I was still worried.

Dr. L did abdominal u/s first and instantly located the sac and fetal pole, but we couldn't tell whether there was a heart beat. He then did TVUS, but couldn't see anything. I told him to let me per and try again since u r supposed to do TVUS on empty bladder anyway.  So we took a potty break. When we came back, he told me that my embryo seemed implanted very high up in the uterus, and kept looking for it higher up in the uterus.  Coincidentally, there was a small fluid sac there. We looked and looked and there was nothing inside. It was empty!!! "Did you have any abnormal discharge?" I was like that cannot be it. I told him that my OB found it really low and close to cervix. So he tried again and thank god found the sac with the fetal pole. And there was a heart beat!!! He tried to measure it, but it came out 78-80.  I was quite upset b/c I knew what that indicates with such a low HR not picking up it's rates at the time... Dr. L was very patient and said "that couldn't be right. let me try again." He tried multiple times and finally picked up EHR 130bpm! The low HR was maternal HR.  I was soooooooo relieved when I heard him saying - "I think you have a viable pregnancy."  

And I was soooo angry at the lab of my PCP's clinic. A 2000/24% difference on a b-hCG test is so outrageous and totally unacceptable. I wrote a complaint to my PCP, but no one responded yet. We'll get this resolved next week. At least, their clinic needs to pay the ER cost due to their lab error, start a full investigation, provide official explanation and apologies to the patient for an unbelievable error like this!

It was such a crazy day. I cancelled my OB f/u appt next week and decide to stop ruining anymore monitoring labs so as not to be freaked out again. Now that my baby had a strong HR, I felt much safer and more confident that this pregnancy is finally for real... I don't feel threatened anymore.  Granted the awkward implantation site will pose challenges to the pregnancy and puts me at high risk for placenta previa, but I'm sure Dr. R can manage it well.

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